Východiska: Mobilní aplikace MOÚ MindCare má za sebou první rok fungování na Masarykově onkologickém ústavu (MOÚ) v rámci randomizované kontrolované studie hodnotící její efektivitu. Cílem příspěvku je shrnout první výsledky vyplývající z procesu náboru pacientů a poukázat na úskalí implementace eHealth programu na podporu duševního zdraví do běžné praxe. Metody: Nábor pacientů do studie MOÚ MindCare probíhá na MOÚ od června roku 2022. Cesty náboru jsou tvořeny z několika úrovní. V rámci mediální propagace byly zvoleny následující komunikační kanály: reklamní bannery v čekárnách, podcasty a rozhlasové vysílaní, webové stránky, sociální sítě a cca 5 000 ks letáků. Druhou úrovní komunikace je aktivní oslovování pacientů studiovými koordinátory přímo na MOÚ. K 30. červnu 2023 bylo do studie zaregistrováno celkem 408 pacientů. Součástí sběru dat je zaznamenávání základních údajů o pacientech (demografické údaje, klinické stadium onemocnění, záměr léčby atp.), ale i důvody odmítnutí vstupu do studie. Stejně tak je sledováno předčasné ukončení v jednotlivých fázích studie. Výsledky: Výsledky naznačují, že pacientky s diagnózou karcinom prsu vykazují vyšší adherenci k účasti ve studii. Nejčastějšími důvody odmítnutí vstupu do studie je: nezájem o psychologickou intervenci, nedostatek času, absence chytrého telefonu nebo nedostatečná technická zdatnost. Z rozhovorů s oslovenými pacienty je zřejmé, že duševní zdraví, a zejména pak vlastní péče o něj, není stále dostatečně srozumitelným tématem, a to i přesto, že velké množství osob léčící se s onkologickou diagnózou zažívá v některé fázi onemocnění distres. Závěr: Z naších prvních zkušeností vyplývá, že způsob náboru, kontext a průběh studie, pohlaví respondentů a také jejich diagnóza mají zásadní vliv na adherenci k programu a drop out ze studie.
Background: The MOÚ MindCare mobile application has completed its first year of operation at the Masaryk Memorial Cancer Institute (MMCI) as part of a randomized controlled trial evaluating its effectiveness. The aim of this contribution is to summarize the first results stemming from the patient recruitment process and to highlight the challenges of implementing an eHealth program to support mental health in routine practice. Methods: Patient recruitment for the MOÚ MindCare study has been conducted at the MMCI since June 2022. The recruitment strategies involve several levels. For media promotion, the following communication channels were chosen: advertising banners in waiting rooms, podcasts, radio broadcasts, websites, social media, and approx. 5,000 leaflets. The second level of communication involves active engagement with patients by study coordinators directly at the MMCI. As of June 30, 2023, a total of 408 patients have been registered in the study. Data collection includes recording basic patient information (demographics, clinical stage of illness, treatment intentions, etc.), as well as reasons for study refusal and premature termination in various study phases. Results: The results show that patients diagnosed with breast cancer show higher adherence to study participation. The most common reasons for study refusal include disinterest in psychological intervention, lack of time, absence of a smartphone, or insufficient technical ability. From conversations with approached patients, it is evident that mental health, particularly self-care, remains an insufficiently comprehensible topic, even though we know that a considerable number of individuals undergoing cancer treatment experience distress at some stage of the illness. Conclusion: Based on our first experiences, recruitment methods, study context, respondents’ gender, and their diagnosis have a significant impact on program adherence and study drop-out rates.
- MeSH
- dospělí MeSH
- duševní zdraví MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mobilní aplikace MeSH
- nádory * psychologie MeSH
- randomizované kontrolované studie jako téma MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- telemedicína * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
BACKGROUND: A growing body of literature shows that psychological distress is not only a major threat to psychological well-being but can also have a significant impact on physical health. In cancer patients, it can negatively affect prognosis and posttreatment recovery processes. Since face-to-face psychological interventions are often inaccessible to cancer patients, researchers have recently been focusing on the effectiveness of eHealth adaptations of well-established approaches. In this context, there has been a call for high-quality randomised controlled trials that would allow for a direct comparison of different approaches, potentially addressing different needs and preferences of patients, and also for more systematic research focusing on how psychological interventions affect not only psychological but also biological markers of stress. Both of these questions are addressed in the present study. METHODS: A randomised controlled trial will be carried out to test and compare the effectiveness of three eight-week eHealth programmes for the mental health support of cancer patients. All programmes will be delivered through the same application for mobile devices MOU MindCare. N = 440 of breast cancer survivors will be recruited at the end of their adjuvant treatment (chemotherapy, radiotherapy, or both) and randomly assigned to one of the three interventions - Mindfulness-Based Cognitive Therapy for Cancer (MBCT-Ca), Positive Psychology (PP), or Autogenic Training (AT) - or the treatment-as-usual (TAU) control group. Psychological and biological markers of stress and adaptive functioning will be assessed at baseline (T0), post-treatment (T1), three-month follow-up (T2), and nine-month follow-up (T3). Primary outcomes will include heart-rate variability and self-report measures of depression, anxiety, perceived stress, general quality of life, and positive mental health. Secondary outcomes will include the levels of serum cortisol and immunomarkers, sleep quality, fatigue, common health symptoms, and several transdiagnostic psychological variables that are expected to be specifically affected by the MBCT-Ca and PP interventions, including dispositional mindfulness, emotion regulation, self-compassion, perceived hope, and gratitude. The data will be analysed using the mixed model repeated measures (MMRM) approach. DISCUSSION: This trial is unique in comparing three different eHealth interventions for cancer patients based on three well-established approaches to mental health support delivered on the same platform. The study will allow us to examine whether different types of interventions affect different indicators of mental health. In addition, it will provide valuable data regarding the effects of stress-reducing psychological interventions on the biomarkers of stress playing an essential role in cancer recovery processes and general health.
- Publikační typ
- časopisecké články MeSH
BACKGROUND/AIM: To evaluate the prognostic value of Response Evaluation Criteria In Solid Tumors (RECIST), modified RECIST and volumetric analysis in patients with hepatocellular carcinoma (HCC) treated by transarterial chemoembolization (TACE). PATIENTS AND METHODS: This single-center prospective cohort study included a total of 61 patients with HCC treated by transarterial chemoembolization (TACE). The response of TACE was evaluated on preprocedural and postprocedural CT by two radiologists using RECIST/mRECIST and volumetric response to treatment. Each response assessment method was used to classify the response as progressive disease, stable disease, partial response and complete response. Kaplan-Meier analysis with log-rank test was performed for each method to evaluate its ability to help predict overall survival and progression free survival. Interobserver variability and reproducibility was determined by the Pearson and Spearman correlation coefficients. RESULTS: The median overall survival was 17.1 months and the median progression-free survival was 11.1 months. Volumetric assessment was proved to be a prognostic factor for overall survival (p<0.01) and progression-free survival (p<0.001), contrasting with RECIST and mRECIST. All three methods featured very small interobserver variability (p<0.001 for Pearson and Spearman correlation coefficients). The patients classified as having stable disease had a 3.8-fold higher risk of death than the patients classified as having a complete/partial response (HR=3.82; 95% Confidence Interval (CI)=1.32-11.02; p=0.013) and a 4.5-fold higher risk of progression (HR=4.46; 95% CI=1.72-11.61; p=0.002). CONCLUSION: The prognostic value of volumetric analysis in patients with HCC treated by TACE appears to be superior to RECIST and mRECIST, with a real impact in everyday practice.
- MeSH
- digitální technologie metody MeSH
- lékařská informatika * metody MeSH
- lékařská onkologie * metody MeSH
- lidé MeSH
- nádory diagnóza prevence a kontrola terapie MeSH
- paliativní péče klasifikace metody MeSH
- průzkumy a dotazníky MeSH
- sběr dat MeSH
- telemedicína metody MeSH
- zdravotnická komunikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
